Clerkship Scheduling Hand Out 2014

Clerkship Draw Mechanics Meeting Handout 2014-2015 Page 1

T A B L E O F C O N T E N T S

2014-2015 Calendar of Clerkship Periods ..................................................................................... 2 Clerkship Year 2014-2015 Period Dates ....................................................................................... 3 2015-2016 Calendar of Clerkship Periods ..................................................................................... 4 Clerkship Year 2015-2016 Period Dates ....................................................................................... 5 2014-2016 Clerkship Scheduling Calendar .................................................................................... 6 Advice from the Advising Deans March 2014 .............................................................................. 8

SECTION I. THE CLERKSHIP CURRICULUM .......................................................................... 9 Required Clerkships ...................................................................................................................... 9 Selective I: Fundamentals of Clinical Care .................................................................................. 10 Selective II: Subinternship .......................................................................................................... 11 Index of Clinical Clerkships .......................................................................................................... 12 Clerkships With No Core Clerkship Prerequisites ........................................................................ 14 Clerkships Offered for Two Weeks .............................................................................................. 14 Clerkships Requiring Prior Approval Before Registering .............................................................. 14 Special Clinical Electives (398A Clerkships) ................................................................................ 14 SECTION II. ENTERING CLERKSHIP DRAW REQUESTS ONLINE ................................... 15 The Clerkship Scheduling Process 2014 ..................................................................................... 15 Clerkship Petitions Committee ..................................................................................................... 16 Clerkship Draw Program .............................................................................................................. 16 Visual Representation of the Schedule ........................................................................................ 16 Entering Draw Requests for Academic Years 2014-2016 ............................................................ 17 The Second Draw ........................................................................................................................ 21

SECTION III. OTHER CLINICAL REQUIREMENTS .............................................................. 24

Student Duty Hours and Work Environment ................................................................................ 24 Respectful Educator and Mistreatment Policy .............................................................................. 25 Guidelines for Coordinating Clerkships & MedScholars Projects ................................................. 30 INDE 297: Reflections, Research and Advances in Patient Care ................................................ 31 Links for Other Clinical Requirements .......................................................................................... 33 Working in the Clinical and Lab Setting: Universal Precautions and Needlestick Protocol .......... 34

SECTION IV. CONTACT INFORMATION ................................................................................ 36


2014-2015 CALENDAR OF CLERKSHIP PERIODS

SUMMER QUARTER PERIOD 1 June 30 - July 27, 2014 PERIOD 2 July 28 - August 24, 2014 PERIOD 3 August 25 - September 21, 2014

AUTUMN QUARTER

PERIOD 4 September 22 - October 19, 2014 PERIOD 5 October 20 - November 16, 2014 PERIOD 6 November 17 - December 14, 2014

HOLIDAY BREAK December 15, 2014 January 4, 2015

WINTER QUARTER

PERIOD 7 January 5 February 1, 2015 PERIOD 8 February 2 March 1, 2015 PERIOD 9 March 2 March 29, 2015

SPRING QUARTER

PERIOD 10 March 30 - April 26, 2015 PERIOD 11 April 27 - May 24, 2015 PERIOD 12 May 25 - June 21, 2015

SUMMER BREAK June 22 June 28, 2015

DATES FOR SCHEDULING VISITING STUDENTS

Visiting students will be scheduled as follows:

SUMMER QUARTER (Periods 1, 2, 3) May 9, 2014 AUTUMN QUARTER (Periods 4, 5, 6) August 8, 2014 WINTER QUARTER (Periods 7, 8, 9) November 7, 2014 SPRING QUARTER (Periods 10, 11, 12) February 6, 2015


CLERKSHIP YEAR 2014-2015 PERIOD DATES

PERIOD PERIOD START

DATE PERIOD END DATE

Period 1 6/30/2014 7/27/2014 Period 1A 6/30/2014 7/13/2014 Period 1B 7/14/2014 7/27/2014 Period 2 7/28/2014 8/24/2014 Period 2A 7/28/2014 8/10/2014 Period 2B 8/11/2014 8/24/2014 Period 3 8/25/2014 9/21/2014 Period 3A 8/25/2014 9/7/2014 Period 3B 9/8/2014 9/21/2014 Period 4 9/22/2014 10/19/2014 Period 4A 9/22/2014 10/5/2014 Period 4B 10/6/2014 10/19/2014 Period 5 10/20/2014 11/16/2014 Period 5A 10/20/2014 11/2/2014 Period 5B 11/3/2014 11/16/2014 Period 6 11/17/2014 12/14/2014 Period 6A 11/17/2014 11/30/2014 Period 6B 12/1/2014 12/14/2014 Period 7 1/5/2015 2/1/2015 Period 7A 1/5/2015 1/18/2015 Period 7B 1/19/2015 2/1/2015 Period 8 2/2/2015 3/1/2015 Period 8A 2/2/2015 2/15/2015 Period 8B 2/16/2015 3/1/2015 Period 9 3/2/2015 3/29/2015 Period 9A 3/2/2015 3/15/2015 Period 9B 3/16/2015 3/29/2015 Period 10 3/30/2015 4/26/2015 Period 10A 3/30/2015 4/12/2015 Period 10B 4/13/2015 4/26/2015 Period 11 4/27/2015 5/24/2015 Period 11A 4/27/2015 5/10/2015 Period 11B 5/11/2015 5/24/2015 Period 12 5/25/2015 6/21/2015 Period 12A 5/25/2015 6/7/2015 Period 12B 6/8/2015 6/21/2015


2015-2016 CALENDAR OF CLERKSHIP PERIODS

SUMMER QUARTER PERIOD 1 June 29 - July 26, 2015 PERIOD 2 July 27 - August 23, 2015 PERIOD 3 August 24 - September 20, 2015

AUTUMN QUARTER

PERIOD 4 September 21 - October 18, 2015 PERIOD 5 October 19 - November 15, 2015 PERIOD 6 November 16 - December 13, 2015

HOLIDAY BREAK December 14, 2015 January 3, 2016

WINTER QUARTER

PERIOD 7 January 4 January 31, 2016 PERIOD 8 February 1 February 28, 2016 PERIOD 9 February 29 March 27, 2016

SPRING QUARTER

PERIOD 10 March 28 - April 24, 2016 PERIOD 11 April 25 - May 22, 2016 PERIOD 12 May 23 - June 19, 2016

SUMMER BREAK June 20 June 26, 2016

DATES FOR SCHEDULING VISITING STUDENTS

Visiting students will be scheduled as follows:

SUMMER QUARTER (Periods 1, 2, 3) May 8, 2015 AUTUMN QUARTER (Periods 4, 5, 6) August 7, 2015 WINTER QUARTER (Periods 7, 8, 9) November 6, 2015 SPRING QUARTER (Periods 10, 11, 12) February 5, 2016


CLERKSHIP YEAR 2015-2016 PERIOD DATES

PERIOD PERIOD START

DATE PERIOD END DATE

Period 1 6/29/2015 7/26/2015 Period 1A 6/29/2015 7/12/2015 Period 1B 7/13/2015 7/26/2015 Period 2 7/27/2015 8/23/2015 Period 2A 7/27/2015 8/9/2015 Period 2B 8/10/2015 8/23/2015 Period 3 8/24/2015 9/20/2015 Period 3A 8/24/2015 9/6/2015 Period 3B 9/7/2015 9/20/2015 Period 4 9/21/2015 10/18/2015 Period 4A 9/21/2015 10/4/2015 Period 4B 10/5/2015 10/18/2015 Period 5 10/19/2015 11/15/2015 Period 5A 10/19/2015 11/1/2015 Period 5B 11/2/2015 11/15/2015 Period 6 11/16/2015 12/13/2015 Period 6A 11/16/2015 11/29/2015 Period 6B 11/30/2015 12/13/2015 Period 7 1/4/2016 1/31/2016 Period 7A 1/4/2016 1/17/2016 Period 7B 1/18/2016 1/31/2016 Period 8 2/1/2016 2/28/2016 Period 8A 2/1/2016 2/14/2016 Period 8B 2/15/2016 2/28/2016 Period 9 2/29/2016 3/27/2016 Period 9A 2/29/2016 3/13/2016 Period 9B 3/14/2016 3/27/2016 Period 10 3/28/2016 4/24/2016 Period 10A 3/28/2016 4/10/2016 Period 10B 4/11/2016 4/24/2016 Period 11 4/25/2016 5/22/2016 Period 11A 4/25/2016 5/8/2016 Period 11B 5/9/2016 5/22/2016 Period 12 5/23/2016 6/19/2016 Period 12A 5/23/2016 6/5/2016 Period 12B 6/6/2016 6/19/2016


2014-2016 CLERKSHIP SCHEDULING CALENDAR

Monday, March 3, 2014 Orientation on Draw Mechanics for Incoming Clinical Students

6:00 pm 8:00 pm LKSC 120 The Draw for Academic Years 2014-15 and 2015-16 will be opened online at the Clerkship Fishbowl

System (Online Fishbowl) at http://medfishbowl.stanford.edu/

Note: Student usernames and passwords are necessary for data entry. Username is the Stanford Student ID number (without the initial 0), and the initial password for all incoming clinical students is TEST. Students should change their password once they are in the Draw system by clicking the User Info tab. Students who have used the system for MedScholars may have set up their own password. Use your MedScholars password to access the system.

Students enter their clerkship draw requests for Medicine, Surgery, and two other cores of the students

choice into the Clerkship Fishbowl System (Online Fishbowl) at http://medfishbowl.stanford.edu One-on-one assistance in entering the Draw requests online is available throughout this period. Please

contact Caroline Cheang at [email protected] to set up an appointment. Wednesday, April 2, 2014 Clerkship Draw for Medicine, Surgery and two Core Clerkships of the students choice The Deadline to enter Draw requests for Medicine, Surgery, and two other cores of the students choice for

academic years 2014-15 and 2015-16 is Wednesday, April 2, 2014 at 7:58 a.m. 8:00 a.m. - Clerkship scheduling (The FIRST DRAW FOR MEDICINE, SURGERY, AND TWO OTHER

CORES OF THE STUDENTS CHOICE) will be run for Academic Years 2014-15 and 2015-16 (clerkship periods beginning June 30, 2014 through June 19, 2016).

At noon - Draw results will be posted online in the Clerkship Fishbowl System at

http://medfishbowl.stanford.edu/ At noon - The Draw for Academic Years 2014-15 and 2015-16 will be reopened online at the Clerkship

Fishbowl System (Online Fishbowl) at http://medfishbowl.stanford.edu/

Note: Student usernames and passwords are necessary for data entry. Username is the Stanford Student ID number (without the initial 0), and the initial password for all incoming clinical students is TEST.

Students enter their clerkship draw requests for the rest of the core clerkships into the Clerkship Fishbowl

System (Online Fishbowl). One-on-one assistance in entering the Draw requests online is available throughout this period. Please

contact Caroline Cheang at [email protected] to set up an appointment.


Wednesday, April 9, 2014 Clerkship Draw for the Rest of the Core Clerkships The Deadline to enter Draw requests for the rest of the core clerkships for academic years 2014-15 and

2015-16 is Wednesday, April 9, 2014 at 7:58 a.m. 8:00 a.m. - Clerkship scheduling (The SECOND DRAW FOR THE REST OF THE CORE CLERKSHIPS)

will be run for Academic Years 2014-15 and 2015-16 (clerkship periods beginning June 30, 2014 through June 19, 2016).

At noon - Draw results will be posted online in the Clerkship Fishbowl System at

http://medfishbowl.stanford.edu/ Monday, April 21, 2014 (8:00 am) First Weekly Shuffle for Non-Core Clerkships for Academic Years 2014-15 and 2015-16 for all incoming clinical students.


Advice from the Advising Deans March 2014

You are about to begin a very exciting part of your medical training your clinical clerkships in which you will be given increasing responsibility for the care of patients and will have an opportunity to work in various clinical disciplines, one of which will become your career focus. This Clerkship Handout provides information about the logistics of planning your clinical curriculum. Clerkships are constantly evolving, and changes are sometimes made as the academic year progresses. You will find your fellow clinical students to be a great resource, particularly those who are approaching graduation this year. You will also learn about your responsibilities and the faculty expectations of your performance during INDE 206 (spring quarter Practice of Medicine). There are other resources available on the academic advising website, http://med.stanford.edu/md/advising/. You can also meet directly with your advisor, who is available and pleased to work with you to plan your schedule. An important predictor of your success in residency applications will be your performance in the clinical clerkships, especially the core clerkships and the advanced rotations in your field of training. Therefore, it is in your interest to give clerkships your complete, most passionate and undivided attention, and minimize your involvement in other activities during this time. Your emphasis should be on receiving a comprehensive clinical education, regardless of your eventual choice of specialty. A goal of the Stanford curriculum is for each graduate to have outstanding general clinical competence, and students who have devoted themselves to clerkships fully have achieved this goal. Several weeks after the completion of each clerkship you will receive an evaluation of your performance, prepared by the director after receiving input from the people with whom you have worked. Your performance in your core clerkships will be evaluated by the new CBEI (criterion-based evaluation initiative) system, details of which will be explained to you later this spring. Evaluations from all clinical clerkships in the first clinical year and from periods 1-2 in the graduation year will be included in your Medical School Performance Evaluation (Deans) letter. The deadline for creation of the MSPE, as outlined by the AAMC, is October 1 each year. If you have any concerns about your experience on a clerkship or your evaluation, please contact your advising dean, who can point you in the right direction to resolve the issue. This should be done as soon as possible, since early intervention is more likely to result in satisfactory resolution. Enjoy the year! It can be an amazing period of growth of your skills and confidence.


SECTION I. THE CLERKSHIP CURRICULUM

For complete information on policies related to clerkship activities, please see the clerkship curriculum section of the current version of the MD program handbook, available online: http://med.stanford.edu/md/policies/

Required Clerkships:

Students must have successfully completed all pre-clinical courses prior to beginning clerkships. NOTE: Graduation requirements for clinical training are subject to change.

Clerkship # Department Title Units

To be completed within the students first 12 months:

MED 300A Medicine General Medicine Core 12 (2 months)

SURG 300A Surgery General Surgery 12 (2 months)

Two of the clerkships below (assigned by draw process) must also be completed within students first 12 months:

ANES 306A or P Anesthesia Critical Care Core 6 (1 month)

FAMMED 301A Family & Community Medicine Family Medicine Core 6 (1 month)

MED 313A Medicine Ambulatory Internal Medicine 6 (1 month)

NENS 301A Neurology Neurology Core 6 (1 month)

OBGYN 300A Obstetrics & Gynecology Basic Obstetrics & Gynecology 9 (1.5 months)

PEDS 300A Pediatrics Child Health 12 (2 months)

PSYC 300A Psychiatry Basic Core Psychiatry 6 (1 month)

These clerkships may be completed any time prior to graduation:

Selective I: Fundamentals of Clinical Care (chosen from approved list) 6 (1 month)

Selective II: Subinternship (chosen from approved list) 6 (1 month)

ELECTIVE 6 (1 month)

Total clinical units required for graduation 93 (15.5 months)

Periods 6 and 7 of the final clinical year are blocked for interviews and USMLE Step 2 preparation. Students must begin the following clerkships no later than Period 7 of the final clinical year.

Internal Medicine Obstetrics and Gynecology Pediatrics Surgery

Students must begin the following clerkships no later than Period 9 of the final clinical year.

Neurology Psychiatry

Students must begin the following clerkships no later than Period 10 of the final clinical year.

Ambulatory Medicine Critical Care Family Medicine

Periods 11 and 12 of the final clinical year are not available for Core Clerkship scheduling.


Selective I: Fundamentals of Clinical Care Students must complete one month of clerkship(s) from the Selective I list.

Goals: Through experiences that broaden their general professional education in areas not covered in a core

clerkship, students will: Achieve excellence in command of the fundamentals of clinical medicine with emphasis on skills

required of all physicians Gain a solid foundation in general medicine as a basis for understanding and treating disease Requisites: Emphasizes common problems in an area essential for a generalist Provides knowledge, skills and attitudes that will enhance development as a well-rounded physician

OR Goals: Through an intensive ambulatory experience, students will: become competent at managing problems in an ambulatory setting strengthen ability to perform a directed history and physical examination appreciate longitudinal management of chronic disease develop time management skills during patient encounters develop a sense of obligation to the health of the public Requisites: At least 75% of experience should be in an ambulatory/outpatient setting Accepts direct responsibility for patients including first to encounter patient, performs procedures, counsels

patients, writes notes and orders Provides opportunities for patient follow-up

Selective I List: Fundamentals of Clinical Care Approved Clerkships

Department Clerkship # Clerkship Name Location Anesthesia 304A Chronic Pain Management SUMC, SMOC Dermatology 300A Dermatology SUMC, PAVAMC, KPMC Family & Community Medicine 310A Continuity of Care Various Family & Community Medicine 344E Family Medicine Elective SJMC Family & Community Medicine 345E* Family Practice Office Various Office Sites Medicine 303A,B,C Cardiology SUMC, PAVAMC, SCVMC Medicine 306A Endocrinology & Metabolism SUMC, PAVAMC, SCVMC Medicine 322A Outpatient Medical Oncology SUMC Medicine 338A HIV Outpatient Elective HOPE Medicine 342A Geriatric Medicine SUMC, PAVAMC Medicine 343B Palliative Care SUMC, PAVAMC, SCVMC Ophthalmology 300E Ophthalmology VAPAHCS-Livermore Orthopedic Surgery 303C Rehabilitation Medicine SCVMC Orthopedic Surgery 304A* Physical Medicine and Rehabilitation SUMC, PAVAMC, SCVMC Orthopedic Surgery 306A Orthopedics SUMC, PAVAMC, SCVMC Otolaryngology 307A* Otolaryngology SUMC, PAVAMC, SCVMC Pediatrics 311E Preceptor at Palo Alto Medical Foundation PAMF Pediatrics 315A Adolescent Medicine LPCH Pediatrics 340D Child Health KPMC Psychiatry 328E* Addiction Treatment Services MPVAMC Radiation Oncology 300A Radiation Oncology SUMC Radiology 301A Diagnostic Radiology & Nuclear Medicine SUMC Surgery 313A,C,D Emergency Medicine SUMC, SCVMC, KPMC Urology 308A,B,C Urology SUMC, PAVAMC, SCVMC

* Available as both a two-week and four-week rotation. If students chose a two-week rotation, they must pair it with another two-week rotation to receive selective credit.


Selective II: Subinternship

Students must complete one clerkship from the Selective II List

Goals: Through an intensive inpatient experience, students will: Assume a high level of patient care responsibility in preparation for residency. Strengthen their clinical and procedural skills. Improve their ability to manage complex, acutely ill patients. Learn to work as team members.

Requisites: Student is responsible for direct management and care of patients with a significantly higher level of responsibility than during core clerkships. Builds upon knowledge and skills learned during the core clerkship. Internship-like responsibilities, e.g., primary workup of new patients, writes orders, performs procedures, participates in daily care, takes night call, writes notes and dictates discharge summary.

Selective II List: Subinternship Approved Clerkships

Department Clerkship # Clerkship Name Location

Cardiothoracic Surgery 300A Cardiothoracic Surgery SUMC Cardiothoracic Surgery 301B Adult Cardiothoracic Surgery PAVAMC Family & Community Medicine 364E Subinternship in Family Medicine OConnor Medicine 304A Cardiovascular Medicine-Inpatients SUMC Medicine 311D Advanced Medicine KPMC Medicine 312C Advanced Medicine SCVMC Medicine 314A Advanced Medicine SUMC Medicine 321A Inpatient Medical Oncology SUMC Medicine 339B Advanced Medicine PAVAMC Neurology 307A Advanced Clinical Elective in Child Neurology SUMC Neurology 308A Advanced Clinical Elective in Adult Neurology SUMC Neurosurgery 318A Subinternship in Neurosurgery SUMC Obstetrics & Gynecology 304A* Inpatient Gynecology SUMC Obstetrics & Gynecology 307A* Maternal-Fetal Medicine SUMC Obstetrics & Gynecology 308A* Gynecologic Oncology SUMC Orthopedic Surgery 318A Subinternship in Orthopedic Surgery SUMC, PAVAMC, SCVMC Otolaryngology 336A Subinternship in Otolaryngology SUMC Pediatrics 313A Neonatal Intensive Care Subinternship LPCH Pediatrics 314A Pediatric Intensive Care LPCH Pediatrics 335A Pediatric Hematology and Oncology Subinternship LPCH Pediatrics 338A Subinternship in Inpatient Pediatrics LPCH Pediatrics 338C Subinternship in Pediatrics SCVMC Surgery 311C Clerkship at the Burn Center SCVMC Surgery 316A Pediatric Surgery SUMC Surgery 333A Multi-Organ Transplantation SUMC Surgery 334A Advanced Vascular Surgery SUMC Surgery 338A Advanced Surgery SUMC, PAVAMC Urology 310B Advanced Surgery/Urology PAVAMC Urology 338A Advanced Urology SUMC

* Available as both a two-week and four-week rotation. If students chose a two-week rotation, they must pair it with another two-week rotation to receive selective credit.


Index of Clinical Clerkships

ANESTHESIA ANES 300A Anesthesia Operating Room Clerkship (SUMC)

ANES 300B Anesthesia Operating Room Clerkship (PAVAHCS)

ANES 300C Anesthesia Operating Room Clerkship (SCVMC)

ANES 300D Anesthesia Operating Room Clerkship (KPMC)

ANES 300E Anesthesia Operating Room Clerkship (SUMC, Surgicenter of Palo Alto, Recovery Inn of Menlo Park)

ANES 300P Pediatric Anesthesia Clerkship (LPCH)

ANES 301A Intensive Care Unit Clerkship (SUMC)

ANES 302A Obstetrical Anesthesia Clerkship (LPCH)

ANES 304A Chronic Pain Management Clerkship (SUMC, SMOC)

ANES 306A Critical Care Core Clerkship Adult (SUMC, PAVAMC)

ANES 306P Neonatal and Pediatric ICU Core Clerkship (LPCH)

ANES 307A Cardiovascular Anesthesia Clerkship (SUMC)

ANES 308A Anesthesia Operating Room Clerkship; Associated Anesthesiologists (SUMC)

ANES 340B Critical Care Clerkship (PAVAMC)

ANES 398A Special Clinical Elective in Anesthesia (SUMC, PAVAMC, SCVMC, KPMC)

CARDIOVASCULAR SURGERY CTS 300A Cardiothoracic Surgery Clerkship (SUMC)

CTS 303A Advanced Thoracic Surgery Clerkship (SUMC)

CTS 301B Adult Cardiothoracic Surgery Clerkship (PAVAMC)

CTS 398A Clinical Elective in Cardiovascular Surgery (SUMC, PAVAMC)

DERMATOLOGY DERM 300A Dermatology Clerkship (SUMC, PAVAMC, KPMC)

DERM 310B Advanced Clinical Elective in Dermatology (SUMC/VAPAHCS, SUMC/SCVMC)

DERM 398A Clinical Elective in Dermatology (SUMC, PAVAMC, SCVMC, KPMC)

FAMILY MEDICINE FAMMED 301A Family Medicine Core Clerkship (SUMC Hoover Pavilion,

O'Connor, Indian Health Services, community sites, and rural sites)

FAMMED 310A Continuity of Care Clerkship (Various)

FAMMED 311E MSTP Continuity Clerkship (Various)

FAMMED 344E Family Medicine Elective Clerkship (SJMC)

FAMMED 345E Family Practice Office Clerkship (Various)

FAMMED 364E Subinternship in Family Medicine (OConnor)

FAMMED 398A Clinical Elective in Family Medicine (SUMC, PAVAMC, SCVMC)

MEDICINE MED 300A General Medicine Core Clerkship (SUMC, PAVAMC, SCVMC,

KPMC)

MED 302A Infectious Diseases Clerkship (SUMC)

MED 302B Infectious Diseases Clerkship (PAVAMC)

MED 302C Infectious Diseases Clerkship (SCVMC)

MED 303A Cardiology Clerkship-Inpatient/Outpatient Consult (SUMC)

MED 303B Cardiology Clerkship (PAVAMC)

MED 303C Cardiology Clerkship (SCVMC)

MED 304A Cardiovascular Medicine Clerkship-Inpatients (SUMC)

MED 305A Hematology Clerkship (SUMC)

MED 306A Endocrinology and Metabolism Clerkship (SUMC, PAVAMC, SCVMC)

MED 307E Palo Alto Medical Clinic Preceptorship (PAMC)

MED 308A Immunology/Rheumatology Clerkship (SUMC)

MED 308C Immunology/Rheumatology Clerkship (SCVMC)

MED 311D Advanced Medicine Clerkship (KPMC)

MED 312C Advanced Medicine Clerkship (SCVMC)

MED 313A Ambulatory Internal Medicine (SUMC, PAVAMC, SCVMC)

MED 314A Advanced Medicine Clerkship (SUMC)

MED 317C Medical ICU Clerkship (SCVMC)

MED 321A Inpatient Medical Oncology Clerkship (SUMC)

MED 322A Outpatient Medical Oncology Clerkship (SUMC)

MED 325A Gastroenterology Clerkship (SUMC)

MED 325B Gastroenterology Clerkship (PAVAMC)

MED 325C Gastroenterology Clerkship (SCVMC)

MED 326A Hepatology Clerkship (SUMC, PAVAMC, etc.)

MED 330A Pulmonary Medicine Clerkship-Rotating (SUMC)

MED 330C Pulmonary Medicine Clerkship (SCVMC)

MED 331A Advanced Work in Pulmonary & Critical Care Medicine (SUMC)

MED 334A Nephrology Clerkship (SUMC, PAVAMC)

MED 334C Nephrology Clerkship (SCVMC)

MED 338A HIV Outpatient Elective (HOPE)

MED 339B Advanced Medicine Clerkship (PAVAMC)

MED 340B Critical Care Clerkship (PAVAMC)

MED 342A Geriatric Medicine Clerkship (SUMC, PAVAMC)

MED 343B Palliative Care Clerkship (SUMC, PAVAMC, SCVMC)

MED 344A Elective in Quality Improvement, Patient Safety, and Organizational Change Clerskhip (SUMC)

MED 398A Clinical Elective in Medicine (SUMC, PAVAMC, SCVMC, KPMC)

NEUROLOGY & NEUROLOGICAL SCIENCES NENS 301A Neurology Core Clerkship (SUMC, PAVAMC, SCVMC, LPCH)

NENS 307A Advanced Clinical Elective in Child Neurology (SUMC)

NENS 308A Advanced Clinical Elective in Adult Neurology (SUMC)

NENS 398A Advanced Clinical Elective in Neurology (SUMC, PAVAMC, SCVMC)

NEUROSURGERY NSUR 304A Neurosurgery Clerkship (SUMC)

NSUR 304B Neurosurgery Clerkship (PAVAMC)

NSUR 304C Neurosurgery Clerkship (SCVMC)

NSUR 318A Subinternship in Neurosurgery (SUMC)

NSUR 398A Clinical Elective in Neurosurgery (SUMC, LPCH, PAVAMC, SCVMC)

OBSTETRICS & GYNECOLOGY OBGYN 300A Basic Obstetrics/Gynecology Clerkship (SUMC, SCVMC, KPMC)

OBGYN 304A Inpatient Gynecology Clerkship (SUMC)

OBGYN 305A Family Planning Clerkship (SUMC)

OBGYN 306A Reproductive Endocrinology-Infertility Clerkship (SUMC)

OBGYN 307A Maternal-Fetal Medicine Clerkship (SUMC)

OBGYN 308A Gynecologic Oncology Clerkship (SUMC)

OBGYN 309C Gynecologic & Obstetric Management & Studies Clerkship (SCVMC)


OBGYN 398A Clinical Elective in Gynecology & Obstetrics (SUMC, SCVMC, KPMC)

OPHTHALMOLOGY OPHT 300A Ophthalmology Clerkship (SUMC, PAVAMC, SCVMC)

OPHT 300E Ophthalmology Clerkship (VAPAHCS Livermore Division)

OPHT 302A Bay Area Ophthalmology Course: Fundamentals in Clinical and Visual Science (SUMC)

OPHT 398A Elective in Ophthalmology (SUMC, PAVAMC, SCVMC)

ORTHOPEDIC SURGERY ORTHO 303C Clinical Clerkship in Rehabilitation Medicine (SCVMC)

ORTHO 304A Physical Medicine & Rehabilitation Clerkship (SUMC, PAVAMC, SCVMC)

ORTHO 306A Orthopedics Clerkship (SUMC, PAVAMC, SCVMC)

ORTHO 310A Hand Surgery Clerkship (SUMC, PAVAMC)

ORTHO 314A Pediatric Orthopedics & Rehabilitation Clerkship (LPCH)

ORTHO 318A Subinternship in Orthopedic Surgery (SUMC, PAVAMC, SCVMC)

ORTHO 398A Clinical Elective in Functional Restoration (SUMC, LPCH, PAVAMC, SCVMC)

OTOLARYNGOLOGY/HEAD & NECK SURGERY OTOHNS 307A Otolaryngology/Head & Neck Surgery Clerkship (SUMC,

PAVAMC, SCVMC)

OTOHNS 336A Subinternship in Otolaryngology/Head & Neck Surgery (SUMC)

OTOHNS 398A Clinical Elective in Otolaryngology/Head & Neck Surgery (SUMC, PAVAMC, SCVMC)

PATHOLOGY PATH 300A Autopsy Pathology Clerkship (SUMC)

PATH 300B Pathology Clerkship (PAVAMC)

PATH 302A Surgical Pathology Clerkship (SUMC)

PATH 304A Clinical Pathology Laboratories (SUMC)

PATH 398A Clinical Elective in Pathology (SUMC, PAVAMC)

PEDIATRICS PEDS 300A Child Health Clerkship Rotating (LPCH, SCVMC)

PEDS 301A Medical Genetics Clerkship (LPCH)

PEDS 302A Pediatric Rheumatology Clerkship (LPCH)

PEDS 303A Pediatric Cardiology Clerkship (LPCH)

PEDS 304A Pediatric Endocrinology and Diabetes Clerkship (LPCH)

PEDS 305A Pediatric Hematology-Oncology Clerkship (LPCH)

PEDS 306A Pediatric Nephrology Clerkship (LPCH)

PEDS 308A Pediatric Gastroenterology and Nutrition Clerkship (LPCH)

PEDS 311E Clinical Preceptorship at the Palo Alto Medical Foundation (PAMF)

PEDS 312A Pediatric Infectious Diseases Clerkship (LPCH)

PEDS 313A Neonatal Intensive Care Subinternship (LPCH)

PEDS 314A Pediatric Intensive Care Clerkship (LPCH)

PEDS 315A Adolescent Medicine (LPCH)

PEDS 316I International Community Health (San Lucas Toliman, Guatemala)

PEDS 335A Pediatric Hematology and Oncology Subinternship (LPCH)

PEDS 338A Subinternship in Inpatient Pediatrics (LPCH)

PEDS 338C Subinternship in Pediatrics (SCVMC)

PEDS 340D Child Health Clerkship (KPMC)

PEDS 398A Clinical Elective in Pediatrics (LPCH, SCVMC, KPMC)

PSYCHIATRY & BEHAVIORAL SCIENCES PSYC 300A Basic Core Psychiatry Clerkship (SUMC, PAVAMC)

PSYC 326A Child Psychiatry Clerkship (LPCH)

PSYC 328E Addiction Treatment Services (VA Menlo Park)

PSYC 333A Sleep Medicine for Medical Students (SUMC)

PSYC 353A Psychosomatic Medicine (Psychiatry Consultation Service) Clerkship (SHC)

PSYC 355A Geriatric Psychiatry (SUMC)

PSYC 398A Advanced Clinical, Research Elective in Psychiatry (SUMC, PAVAMC, SCVMC)

RADIATION ONCOLOGY RADO 300A Radiation Oncology Clerkship (SUMC)

RADO 398A Clinical Elective in Radiation Oncology (SUMC)

RADIOLOGY RAD 301A Diagnostic Radiology and Nuclear Medicine Clerkship (SUMC)

RAD 302A Nuclear Medicine Clerkship (SUMC)

RAD 303A Specialty Clerkship in Diagnostic Radiology (SUMC)

RAD 304A Pediatric Radiology Clerkship (LPCH)

RAD 305A Interventional Radiology Clerkship (SUMC)

RAD 398A Clinical Elective in Diagnostic Radiology & Nuclear Medicine (SUMC, LPCH)

SURGERY SURG 300A General Surgery Clerkship (SUMC, PAVAMC, SCVMC, KPMC)

SURG 309A Plastic Surgery Clerkship (SUMC, PAVAMC, SCVMC, KPMC)

SURG 310A Hand Surgery Clerkship (SUMC, PAVAMC)

SURG 310E Hand and Microsurgery Clerkship (CPMC)

SURG 311C Clerkship at the Burn Center (SCVMC)

SURG 313A Emergency Medicine Clerkship (SUMC)

SURG 313C Emergency Medicine Clerkship (SCVMC)

SURG 313D Emergency Medicine Clerkship (KPMC)

SURG 316A Pediatric Surgery Clerkship (LPCH)

SURG 317A Pediatric Surgical Specialties Clerkship (LPCH)

SURG 333A Multi-Organ Transplantation Clerkship (SUMC)

SURG 334A Advanced Vascular Surgery Clerkship (SUMC)

SURG 338A Advanced Surgery Clerkship (SUMC, PAVAMC)

SURG 340A Critical Care Clerkship (SUMC)

SURG 340B Critical Care Clerkship (PAVAMC)

SURG 398A Clinical Elective in Surgery (SUMC, LPCH, PAVAMC, SCVMC, KPMC)

UROLOGY UROL 308A Urology Clerkship (SUMC)

UROL 308B Urology Clerkship (PAVAMC)

UROL 308C Urology Clerkship (SCVMC)

UROL 310B Advanced Surgery/Urology Clerkship (PAVAMC)

UROL 338A Advanced Urology Clerkship (SUMC)

UROL 398A Clinical Elective in Urology (SUMC, PAVAMC, SCVMC)

*May not be used towards the minimum 15.5 months in clinical clerkships.


Clerkships With No Core Clerkship Prerequisites

The following clerkships, in addition to all core clerkships, are available to students who have not taken a core clerkship:

ANES 300A* MED 303A NSUR 304A PATH 300A PSYC 333A UROL 308A ANES 300B* MED 307E NSUR 304B PATH 300B RAD 301A* UROL 308B ANES 300C* MED 326A NSUR 304C PATH 302A RAD 304A UROL 308C ANES 304A* MED 334A* OPHT 300A PATH 304A RAD 305A*

ANES 308A* MED 342A ORTHO 304A PEDS 311E* RADO 300A DERM 300A MED 344A OTOHNS 307A PSYC 328E SURG 311C

*Core clerkships highly recommended as prerequisite

Clerkships Offered for Two Weeks

ANES 300A ANES 300P FAMMED 345E OBGYN 306A ORTHO 304A RAD 305A ANES 300B ANES 302A MED 308C OBGYN 307A OTOHNS 307A ANES 300C ANES 304A MED 343B OBGYN 308A PEDS 316I ANES 300D ANES 307A OBGYN 304A OBGYN 309C PSYC 328E ANES 300E ANES 308A OBGYN 305A OPHT 300E PSYC 333A

Clerkships Requiring Prior Approval Before Registering

ANES 300E ANES 308A MED 302C MED 340B ORTHO 303C SURG 340B ANES 300P ANES 340B MED 308A NENS 307A PEDS 314A

ANES 301A DERM 310B MED 325C NENS 308A SURG 340A

Special Clinical Electives (398A Clerkships)

Each department has a 398A clerkship. This designation can be used for a student-designed clerkship, provided it has the consent of a faculty preceptor who will supervise the student. 398A clerkships must be clinical, not research.

Students cannot add 398A clerkships directly to their Fishbowl schedules through the regular shuffles. To add a 398A clerkship, contact the Assistant Director of Clerkship Administration in the School of Medicine Registrars Office at [email protected] or 650-498-7619 with the faculty preceptors name and email address, the period and duration of the clerkship.


SECTION II. ENTERING CLERKSHIP DRAW REQUESTS VIA THE ONLINE CLERKSHIP FISHBOWL SYSTEM

The Clerkship Scheduling Process 2014

1. All students will participate in the Clerkship Draw (i.e., there will be no petitioning for exemption from the Draw.)

2. Each student will propose a schedule (according to rules specified for the Clerkship Draw) covering both clinical years that includes all of the following clerkships: Ambulatory Medicine (MED 313A), Critical Care (ANES 306A or ANES 306P), Family Medicine (FAMMED 301A), Medicine (MED 300A), Neurology (NENS 301A), Obstetrics and Gynecology (OBGYN 300A), Pediatrics (PEDS 300A), Psychiatry (PSYC 300A), Surgery (SURG 300A).

3. In the second clinical year, Periods 11 and 12 will not be included as an option for scheduling as students cannot complete this prior to graduation.

4. To allow time away for residency interviews, Periods 6 and 7 of the second clinical year will automatically be blocked from scheduling of any core clerkships. Students planning to do a specialty with early or late interviews must contact their advisor to change the blocked periods.

5. In submitting their proposed schedule, students can block up to four clerkship periods in draw 2 to be held as open or unscheduled when the program runs. Students will be encouraged to block at least two months between Period 11 of the first clinical year and Period 3 of the second clinical year for their subinternships.

6. Clerkships will be filled each period only to a maximum number as determined by the clerkship director. No exceptions will be made.

7. Medicine 300A and Surgery 300A must be scheduled within the first twelve months of starting clinical clerkships.

8. Two additional clerkships must be scheduled within the first twelve months of starting clinical clerkships. (Note: Critical Care will only be scheduled after the prerequisites are scheduled. Prerequisites: ANES 306A SURG 300A and MED 300A; ANES 306P SURG 300A and PEDS 300A.)

9. Obstetrics and Gynecology 300A and Pediatrics 300A must be started by Period 7 of the graduation year.

10. Neurology 301A and Psychiatry 300A must be started by Period 9 of the graduation year.

11. Ambulatory Medicine 313A, Critical Care 306A or 306P, and Family Medicine 301A must be started by P10 of the graduating year.

12. An NBME subject examination is currently administered for Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery.

13. The Draw will generate a schedule for every student containing all of the clerkships specified above. Cases where a student wishes to adjust the blocked period or to request consideration for exception to the scheduling rules will be handled on an individual basis through the petition process.

14. Using the weekly shuffle, students will schedule the Basics in Clinical Care Selective, the Subinternship, and any elective clerkships they wish to take.

15. Students cannot drop any core clerkships scheduled through the Draws from their schedules through the weekly shuffle (i.e., all of the specified clerkships must appear on a students schedule at all times). Students may swap clerkships if there is an empty slot or if they can identify another student with whom to swap by contacting the Assistant Director of Clerkship Administration.


Clerkship Petitions Committee

If a student has compelling reasons for a core clerkship schedule change, it is necessary that the student first consult with his/her advisor. The advisor will work with the Assistant Director of Clerkship Administration to determine if the requested adjustment can be made without violating the scheduling criteria. If the requested change violates scheduling criteria, the student may choose to file the request with the Petitions Committee. The Petitions Committee will hear requests for exception to the scheduling rules.

Clerkship Draw Program

The Clerkship Draw program is a computerized scheduling program. The program is designed to guarantee each student an equal chance of getting desired clerkships. Clerkships are assigned in rounds. Each student is assigned one clerkship in each round. In the first round, the program selects a student randomly, assigns one clerkship to that student, and then moves on to the next randomly selected student. This process continues until all students have one clerkship assigned. In the second round, the program reverses the order of the randomly selected students in the previous round to assign their second clerkship. In the third round, the students are again selected randomly. The fourth round is the reverse order of the third round. This alternating method of scheduling continues until all students draw requests have been processed.

Visual Representation of the Schedule

Note: Clerkship evaluations from period 1 of the first clinical year through period 2 of the second year will be included in the MSPE. Evaluations from period 3 of the second clinical year will be included when possible; for core clerkships requiring results from a shelf or Departmental examination, period 3 evaluations are not available by the MSPE deadline.


Entering Draw Requests For Academic Years 2014-2016

There will be two Draws. The First Draw allows you to request your preferences for Medicine, Surgery and two other core clerskhips of your choice. The Second Draw allows you to request your preferences for the rest of the core clerkships. Log in to the website by going to the following link: http://medfishbowl.stanford.edu Choose the Draw Login menu and enter your student ID number (without the initial 0) and password. The default password for all students is TEST, which should be changed by clicking on the User Info tab after logging in. The following screen will be displayed for your First Draw:

The first step is to choose the periods that will be blocked. You can block a maximum of two periods. To specify your blocked periods, choose the Academic Year and Period from the pull down menus and press the Add to Blocks button. Blocked periods will not be scheduled by the Draw system. Once you have chosen your blocked periods, you can select your two extra cores to be drawn with Medicine and Surgery in the first Draw. Click on the Select Extra Core tab to display the remaining core clerkships. Your screen will look similar to the picture below:


To designate your extra core clerkships, choose the department and course from the pulldown menus and press the Add Extra Core to Draw button. Once you have chosen your extra core, you can choose your period preferences. Click on the Core Selections tab to display the selection grids for the clerkships. Your screen will look similar to the picture below.


Directions for Choosing Your Clerkships

To choose your core clerkship preferences, click on an open period, which will designate that period as your first preference, using the 10 from the Next Num box on the left-hand side of the screen. The Next Num box will then automatically change to 20 in preparation for your next selection. If you make a mistake, you can click on the cell a second time to clear its contents. If you wish to manually assign a numeric value to a cell, you can override the system counter by typing a number into the Next Num box. This number will be used in your next selection. Manual entries do not have to be in increments of 10. If you wish to change the order of your preferences, you may use any number in between. The system will then continue incrementing based on the highest unassigned number. When you have completed your selections for all core clerkships, press the Save Selections button. If you want to completely restart the selection process, press the Clear All button. IMPORTANT: Your selections are NOT complete until you press the Save Selections button. Once you have saved your selections, you can choose the Draw Seq tab to display a list of your selections. You should print this page for your records. This will verify that you have saved your draw selections for the academic years listed. This is the order the Draw system will use to schedule your clerkships. You can change your preferences as often as you like before the draw deadline. Below is an example of the Draw Seq screen:


Changing Your User Information If you would like to change your password or student information, click on the User Info button. The screen below can be updated with any of your student information. It is highly recommended that you change your password during the First Draw. This information can be updated from either your Draw Login or the Shuffle Login. This information should be updated to ensure that the scheduling administrators can contact you for any scheduling conflicts or questions concerning your clerkship selections. The scheduling system uses this email address to notify you of any schedule changes.


The Second Draw

The following menu will be displayed when you login for your Second Draw:

The first step is to choose the periods that will be blocked. You can block a maximum of four periods in the Second Draw. The periods you blocked in the First Draw do not carry over to the Second Draw. Blocked periods will not be scheduled by the Draw system. To specify your blocked periods, choose the Academic Year and Period from the pulldown menus and press the Add to Blocks button. Once you have chosen your blocked periods, you can choose your period preferences.


Click on the Core Selections tab to display the selection grids for the clerkships. Your screen will look similar to the picture below:


Directions for Choosing Your Clerkships To choose your core clerkship preferences, click on an open period, which will designate that period as your first preference, using the 10 from the Next Num box on the left-hand side of the screen. The Next Num box will then automatically change to 20 in preparation for your next selection. If you make a mistake, you can click on the cell a second time to clear its contents. If you wish to manually assign a numeric value to a cell, you can override the system counter by typing a number into the Next Num box. This number will be used in your next selection. Manual entries do not have to be in increments of 10. If you wish to change the order of your preferences, you may use any number in between. The system will then continue incrementing based on the highest unassigned number. When you have completed your selections for all core clerkships, press the Save Selections button. If you want to completely restart the selection process, press the Clear All button. IMPORTANT: Your selections are NOT complete until you press the Save Selections button. Once you have saved your selections, you can choose the Draw Seq button to display a list of your selections. You should print this page for your records. This will verify that you have saved your draw selections for the academic years listed. This is the order the Draw system will use to schedule your clerkships. You can change your preferences as often as you like before the draw deadline.


SECTION III: OTHER CLINICAL REQUIREMENTS

Student Duty Hours and Work Environment

Providing students with a sound academic and clinical education must be carefully planned and balanced with concerns for patient safety and student well-being.

Supervision of students 1. All patient care must be supervised by qualified residents or faculty. 2. Faculty, residents and students must be educated to recognize the signs of fatigue,

and adopt and apply policies to prevent and counteract the potential negative effects.

Duty hours 1. Duty hours are defined as all clinical and academic activities related to the students,

i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

2. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

3. Students must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

In-house call activities The objective of all call activities is to provide students with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal workday when students are required to be immediately available in the assigned institution.

1. In-house call must occur no more frequently than every third night, averaged over a four-week period.

2. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.

3. Students must have a minimum of 8-hours free of duty between scheduled duty periods. Students must have a minimum of 14-hours free of duty after 24-hours of in-house duty.


Respectful Educator and Mistreatment Policy I. Standards

A. Stanford School of Medicine (SoM) is committed to providing a work and educational environment that is conducive to teaching and learning, research, the practice of medicine and patient care. This includes a shared commitment among all members of the SoM community to respect each persons worth and dignity, and to contribute to a positive learning environment where medical students are enabled and encouraged to excel. Given their roles in the educational process and their inherently unequal positions vis a vis students, all instructional personnel (including faculty, residents, and other members of the healthcare team) are to treat students with courtesy, civility and respect and with an awareness of the potential impact of their behavior on such students professional futures.

B. Conduct inconsistent with this policy can occur in a variety of forms and may seriously impair learning. In particular, instructional personnel are expected to create an environment in which feedback regarding their performance can be given openly by students without concern for reprisal, and which is free of exploitation, harassment, impermissible discriminatory treatment, humiliation, or other mistreatment or abuse of medical students. Examples of conduct inconsistent with these standards might include:

Sexual harassment Physical or verbal abuse Assigning duties as punishment rather than education Requiring a student to perform personal services (such as shopping or

babysitting) Unwarranted exclusion from reasonable learning or professional

opportunities Evaluation or grading on inappropriate criteria (or threatening to do so) Harassment or discrimination on the basis of sex, race, age, color, disability,

religion, sexual orientation, gender identity, national or ethnic origin, or any other characteristic protected by applicable law

C. Note: The expectations stated in this policy primarily relate to the standards of conduct for instructional personnel. For their part, medical students are expected to adhere to similar standards of respectful and professional behavior, including (but not limited to) the standards of conduct for students set forth in the MD Program Handbook and Policy Manual (http://med.stanford.edu/md/mdhandbook/)

II. Guidelines For Application

A. These standards of conduct are applicable to all SoM instructional personnel (including faculty, residents and other members of the healthcare team) in their interactions with Stanford medical studentswhether on or off campus and whether in formal educational (such as clinical or classroom) or in social settings.

B. In general, a determination of whether specific conduct is inconsistent with this policy will depend on a case-by-case analysis of the particular facts and circumstances, and the use of a reasonable medical student standard.

C. Students subjected to abuse, discrimination, mistreatment or harassment have a right to seek timely and effective remediation with the full support of the SoM and


Stanford University. In addition, retaliation and/or reprisals against an individual who in good faith reports or provides information in an investigation about conduct that may violate this policy is prohibited.

D. Conduct inconsistent with this policy may consist in repeated actions or may even arise from a single incident if sufficiently egregious.

E. In the review of conduct under this policy, other Stanford University and SoM policies and procedures (such as Stanfords Sexual Harassment and Consensual Sexual or Romantic Relationships Policy) may become relevant.

III. The Respectful Educator and Mistreatment Committee The Respectful Educator and Mistreatment Committee is a standing committee to carry out the purposes and procedures set forth in this policy.

A. The committee meets quarterly, and on an ad hoc basis if it is deemed necessary by the Chair.

B. The committee is chaired by the Associate Dean for Medical Student Life Advising, who is hereafter referred to as the Chair.

C. The composition of the committee includes the following as members: The Chair One or more clinical students An Academic Advising Dean The Director of Graduate Medical Education (or designee) The Director of Clerkships The Director of Educators for CARE A Residency Training Program Director A Resident The Chair of the Physician Wellbeing Committee

D. The committee will keep such confidential records of its proceedings as are appropriate to support its purposes of education and concern resolution.

IV. Procedures The following procedures for handling incidents of potential violations of the Standards of Conduct for the Teacher-Learner Relationship place a strong emphasis on resolving complaints informally. The procedures include advising and mediation. It is important to note that the procedures do not preempt other formal or informal channels available within the University. It is recommended that students should -- as a first step-- contact the Chair of the Respectfult Educator and Mistreatment Committee to review the various options that are available (on a confidential basis as that status is granted to the Associate Dean for Medical Student Life Advising http://med.stanford.edu/md/student-development/confidentiality.html). The Chair of the committee is empowered to explore with the student a plan of action that may include some or all of the steps described below.

A. Informal: Concern about potential violations may be handled by communication with various individuals, including but not limited to the following:

1. Direct discussions (by the student or others) with the alleged offender.


2. Conversation (by the student or others) with individuals such as the chief resident, attending physician, clerkship director, and/or Educator For Care (E4C) faculty.

3. The Chair of the Respectful Educator and Mistreatment Committee may present the concern to all or a portion of the Respectful Educator and Mistreatment Committee, and to such third parties that the Chair of the Respectful Educator and Mistreatment Committee deems appropriate for seeking an informal resolution.

4. The Chair of the Respectful Educator and Mistreatment Committee also may in his/her discretion refer the matter to an alternate available University process or office, such as an existing grievance process or the Sexual Harassment Policy Office or the Director of the Diversity and Access Office.

5. Direct conversation by the student with confidential resources including but not limited to the Ombuds, Counseling and Psychological Services, and the Deans of Religious Life.

Informal solutions to address the problem may be recommended and/or pursued such as (but not limited to) systems changes or educational interventions. The Chair of the committee will be available throughout the process to discuss with the student the status of the matter, including any potential resolution.

B. Formal: If no resolution is reached and the student wishes to proceed with a more formal grievance or complaint process, the Chair of the Respectful Educator and Mistreatment Committee may refer the student to other existing processes or may (in an appropriate case) accept from the student a written grievance or complaint to use the procedure described below.

1. The student should set forth in writing the substance of the grievance or complaint, the grounds for it and the evidence on which it is based, and the efforts taken to date to resolve the matter. It is at this stage that the matter becomes a formal grievance or complaint.

2. The grievance or complaint document should be submitted to the Chair of the Respectful Educator and Mistreatment Committee. A grievance should be filed in a timely fashion, i.e., normally within thirty days of the end of the academic quarter in which the action that is the subject of the grievance or complaint occurred. A delay in filing may be grounds for rejection of that grievance or complaint.

3. The Chair of the Respectful Educator and Mistreatment Committee will review the grievance or complaint and (if it reflects an appropriate use of the process) will then promptly (within 7 days) transmit the grievance or complaint to the Senior Associate Dean for Medical Education (SADME) for handling.

4. The SADME shall promptly initiate a review, which should normally be completed within sixty days. The SADME may attempt to resolve the matter informally, and may refer the matter (or any part of it) to a grievance officer or other designee, who will evaluate and/or address the matter as the SADME directs. The SADME may also, in appropriate cases, remand the matter to the appropriate administrator (including to the administrative level at which the grievance or complaint arose) for further consideration.

5. In undertaking this review, the SADME (or his or her designee) may request a response to the issues raised in the grievance or complaint from any


individuals believed to have information the reviewer considers relevant, including faculty, staff and students.

6. The SADME (or his or her designee) shall issue his or her decision in writing, and take steps to initiate such corrective action as is called for (if any). Conduct meriting discipline shall be brought to the attention of the appropriate disciplinary process.

7. Appeal a. If the student is dissatisfied with the disposition by the SADME (or his

or her designee), he or she may appeal to the Dean of the School of Medicine. The appeal should be filed in writing with the Dean within ten days of the issuance of the decision by the SADME (or his or her designee); a delay in filing the appeal may be ground for rejection of that appeal.

b. The Dean may attempt to resolve the matter informally, and may refer the matter (or any part of it) to a grievance appeal officer or other designee, who will review the matter at the Deans direction. The Dean also may remand the matter to the appropriate administrator (including to the administrative level at which the grievance arose) for further consideration.

c. The Dean should normally complete his or her review of the appeal and issue his or her decision in writing within forty-five days. That decision is final. It is not subject to further review by any other University process.

V. General Provisions

A. Time Guidelines: The time frames set forth herein are guidelines. They may be extended by the Chair of the Respectful Educator and Mistreatment Committee, the SADME or the Dean, as applicable, in his or her discretion for good cause (including for reasons relating to breaks in the academic calendar).

B. Advisers: A student initiating or participating in a grievance or complaint under this procedure may be accompanied by an adviser in any discussion with the Chair of the Respectful Educator and Mistreatment Committee, the SADME, the Dean, or their designees (such as a grievance or grievance appeal officer); such adviser must be a current Stanford faculty, staff member or student.

C. Ombuds: Students should be aware that the University Ombuds (http://www.stanford.edu/dept/ocr/ombuds) is available to discuss and advise on any matters of University concern and frequently helps expedite resolution of such matters. Although it has no decision making authority, the Ombuds Office has wide powers of inquiry.

D. Sexual Harassment and Disability related issues: For further information and resources concerning sexual harassment, students should refer to the web page of the Sexual harassment Policy Office at http://harass.stanford.edu. For further information and resources concerning disabilities and accessible education, students should refer to the web page of the Office of Accessible Education at http://www.stanford.edu/group/DRC/

E. No retaliation: Stanford University prohibits retaliation or reprisals against individuals based on their pursuit in good faith of a grievance or complaint under this procedure, or their participation in good faith in the grievance or complaint process.


F. Standards for Review: If the grievance or complaint involves a decision that is being challenged, the review by the SADME, as well as the review by the Dean on appeal, usually will be limited to the following considerations:

1. Were the proper facts and criteria brought to bear on the decision? Were improper or extraneous facts or criteria brought to bear that substantially affected the decision to the detriment of the grievant?

2. Were there any procedural irregularities that substantially affected the outcome of the matter to the detriment of the grievant?

3. Given the proper facts, criteria, and procedures, was the decision one which a person in the position of the decision maker might reasonably have made?

VI. Education The Stanford School of Medicine will provide ongoing education to promote a positive learning environment and discourage violations of the standards of conduct for the teacher-learner relationship. Such education serves several purposes. First, it promotes an environment of respect for each persons worth and dignity. Second, it informs students that there are procedures available for them to register concerns of educator conduct violations, which can be investigated and addressed without fear of retaliation. Third, it informs instructional personnel of the SoMs standards of conduct and procedures for responding to allegations of violations of these standards. This policy will be included in the MD Program, Resident and Faculty handbooks and posted on the medical school website. Educational sessions on this topic will be introduced during the pre-clerkship curriculum and readdressed early in the clinical curriculum. Educational sessions on this topic will also be presented to educational personnel including but not limited to at forums such as resident orientation, department meetings, and staff meetings. The materials and methods for providing this education will be the responsibility of the Respectful Educator and Mistreatment Committee.


Guidelines for Coordinating Clerkship and MedScholars Projects

Students who plan to either apply for MedScholars during Clerkships, or who want to continue MedScholars work during Clerkships, must be aware of and abide by the following policies and guidelines.

During 100% research quarters, you may not take any Clerkships.

In quarters where you have a full clerkship schedule, you may not hold any MedScholars grants.

MedScholars grants during quarters in which you take a reduced Clerkship

schedule are possible.

25% MedScholars 50% MedScholars 75% MedScholars Must commit to working on the project for 40 hours per week for at least 3 weeks.

Must commit to working on the project for 40 hours per week for at least 6 weeks.

Must commit to working on the project for 40 hours per week for at least 9 weeks.

Must have 3 or more free weeks with no clerkships.



For purposes of this definition, a free week is a week during the regular academic quarter in which there are not other responsibilities during normal work hours Monday-Friday

Clerkship schedules, as recorded by the clerkship program, will be reviewed at various

points in the MedScholars application and approval process.

o During the MedScholars application process, students starting or already in Clerkships, must present their Clerkship schedule and specify which weeks they will be available to complete a MedScholars project.

o Within two weeks of project approval students must demonstrate an approved Clerkship schedule sufficient to allow their approved MedScholars grants in accordance with the above guidelines. If your Clerkship schedule will not allow this your MedScholars approval will be revoked.

o At the start of any quarter in which MedScholars funds are to be disbursed, Clerkship schedules will be reviewed and funding will not be issued if the clerkship schedule does not conform to the above guidelines.

o Students are responsible for advising the MedScholars Coordinator of any Away Clerkships that may affect their project effort.

Some Advice:

Plan your Clerkships as if you have been awarded the MedScholars project you are applying for; it is NOT recommended, and often not possible to adjust your Clerkships after you receive a MedScholars award. The Clerkship program will not view receiving a MedScholars award as sufficient justification for changing your core Clerkship schedule.

If you are planning to complete a full year of full-time research* before starting

Clerkships, please contact the MedScholars program to discuss incorporating POM Q6 with your research schedule.

*If you are applying for Doris Duke, HHMI, Fogarty, Fullbright, etc. please contact the MedScholars Coordinator (http://medscholars.stanford.edu/contact.html) **Remember, you cannot take more than 4 units during 100% MedScholars quarters.


INDE 297: Reflections, Research and Advances in Patient Care In addition to successful completion of 15.5 months of clerkships (93 clinical units), students must fulfill the following graduation requirements during the clinical years. More information about each of these requirements may be found in the relevant sections of the MD Program Handbook (noted below). Reflections, Research, and Advances in Patient Care http://med.stanford.edu/md/curriculum/RRAP.html Attendance and participation in INDE 297 is required for all medical students enrolled in clerkships at Stanford affiliated sites (SHC, LPCH, VAMC, Kaiser Santa Clara and Valley Medical Center). Please note that this applies to students enrolled in required, selective, and elective clerkships. To receive the 4 units of credit for INDE 297, students must:

1. Attend all Doctoring with CARE sessions. Attendance will be taken at all sessions.

2. Attend all Advances and Perspectives in Medicine lecture/seminar series sessions over the two clinical years. Students should sign into E*Value and submit an evaluation for each lecture session attended.

3. Attend all SC breakout meetings (MSTP students are waived). Attendance will be taken at all sessions.

Once a student has attended all Doctoring with CARE sessions, SC breakout meetings, and has attended and evaluated the Advances and Perspectives in Medicine lecture sessions; the School of Medicine Registrars Office will enroll the student in INDE 297 for four units.

Students must contact the course coordinator ([email protected]) to obtain explicit advance approval for any planned absence from the RRAP day at least one week prior to the session to obtain an excused absence. The attendance and absence policy is similar to the clerkship attendance and absence policy as outlined in the MD Program Handbook and Policy Manual.

Dates for INDE 297 (RRAP Day) Sessions for 2014-2015 Clerkship Year: August 15, 2014 (Period 2) October 10, 2014 (Period 4) December 5, 2014 (Period 6)

February 20, 2015 (Period 8) April 17, 2015 (Period 10) June 12, 2015 (Period 12)


RRAP Day Requirement Map

First-Year (including

MSTP)

Second-Year (including

MSTP)

Clinical (including: electives & Sub-I, off-

period)

Clinical (including:

Away Rotation)

Other (including: MSTP-PhD

part) Doctoring with

Care (10-11:30am)

Not Required Not Required Required Not Required Not

Required

E4C Learning Community

Lunch (noon-1pm)

Recommended Recommended Recommended Not Required Not

Required

Advances & Perspectives in

Medicine Lecture

(1:30-2:45pm)

Not Required Recommended Required Not Required Not

Required

SC Breakouts (3-4:30pm,

4x/year) Required Required Required Not Required

Not Required

Students must contact the course coordinator ([email protected]) to obtain explicit advance approval for any planned absence from the RRAP day at least one week prior to the session to obtain an excused absence. Only one excused absence per year is allowed. Remediation pathways will be provided for those students who require more than one excused absence per year. Unanticipated absences for illness or emergency must be communicated to the course coordinator as promptly as possible. Any unexcused absence or failure to communicate with the course coordinator about unavoidable absences is considered reason for failing the course. Attendance and absence policy is hence similar to clerkship attendance and absence policy as outlined in the MD Program Handbook and Policy Manual.


Links for Other Clinical Requirements

2013-2014 MD Program Handbook and Policy Manual

http://med.stanford.edu/md/mdhandbook/

Advanced Cardiac Life Support (ACLS) - MED 295

http://med.stanford.edu/md/mdhandbook/aclsrequirement.html

Clinical Performance Examination (CPX)

http://ome.stanford.edu/spp/students.html#cpx

United States Medical Licensing Examination (USMLE) Requirements

http://med.stanford.edu/md/mdhandbook/usmlerequirements.html

Scholarly Concentration Requirement

http://med.stanford.edu/md/curriculum/scholarly_concentrations/

Stepping Out of the MD Curriculum Sequence

http://med.stanford.edu/md/curriculum/steppingout.html


Working in the Clinical and Lab Setting: Universal Precautions

UNIVERSAL PRECAUTIONS

UNIVERSAL PRECAUTIONS AND NEEDLESTICK PROTOCOL Universal Precautions apply to the handling of all blood, body fluids, and human tissue. Body fluids, also known as other potentially infectious materials (OPIM), include: semen, vaginal secretions, cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids, feces, urine, sputum, nasal secretions, saliva, tears, vomitus or any other body fluid or tissue that is visibly contaminated with blood. Appropriate protection including gloves, mask and gown should be worn to protect oneself from exposure. If you believe you have had a significant exposure to blood or OPIM, IMMEDIATELY wash wound or exposed tissue thoroughly with soap and water. Rinse copiously. Then call the Needlestick Hotline 650-723-8222 then pager 1-STIX which is 1-7849 to talk to a staff person 24/7 who is trained and on call specifically for this purpose. This hotline is to be called by medical students who are rotating at all affiliated hospitals including the PAVA, SCVMC, LPCH, Stanford and Kaiser. There is no need to go to the Emergency Department or Occupational Health unless this is the recommendation from the Needlestick hotline personnel when you call. Records are strictly confidential. There is no charge for blood tests, medications, or follow-up care following a blood or OPIM exposure. If you have any problem using this hotline, please notify Dr. Smith-Coggins either by email or pager. Dr. Smith-Coggins can be reached through hospital page system 650-723-6661 on pager 1-3481. Hand Washing: Hands and other skin surfaces contaminated with blood or body fluids must be immediately and thoroughly washed. Gloves must be changed and hands washed between patient contacts. Protective Barriers: Protective barriers will be worn to prevent exposure to blood or body fluids during procedures where splashing or aerosolization may occur. Individual departments/units will specify the type of protective barrier(s) to be used during any specific procedure, according to the type of exposure anticipated. Barriers such as gloves, gowns, plastic aprons, masks, protective eyewear, or face shields may be required. Gloves: Gloves will be worn during phlebotomy, finger or heel sticks, when starting or manipulating intravascular lines, or during any procedure involving a potential exposure to blood or OPIM: 1. Use sterile gloves for procedures involving contact with normally sterile areas of the body. 2. Use examination gloves for procedures involving contact with mucous membranes or for

other patient care. 3. Change gloves and wash hands between patient contacts. 4. Do not wash or disinfect surgical or examination gloves for reuse (deterioration may result). 5. Use general-purpose utility gloves (e.g. rubber household gloves) for housecleaning chores

and for instrument cleaning and decontamination procedures. Utility gloves may be decontaminated and reused, but should be discarded if peeling, cracked, torn, or damaged.


Preventing Penetrating Injuries: Gloves will reduce the incidence of contamination of the hands, but they cannot prevent penetrating injuries from needles or other sharp instruments. 1. NEVER RECAP NEEDLES BY HAND; do not remove used needles from disposable

syringes by hand and do not bend, break, or otherwise manipulate used needles by hand. 2. Place used disposable syringes, needles, scalpel blades, and other sharp items in red

puncture-resistant containers for disposal. Containers should be located at the bedside or as close to the area as practical.

3. Take care, both during and after procedures, to prevent injuries from needles, scalpels, or other sharp instruments or tools. Always maintain eye contact with these devices.Use of Needleless Systems, Safe Needles and Non-Needle Sharps: Needleless systems are to be used during:

1. Withdrawal of body fluids after initial venous or arterial access is established; 2. Administration of medications or fluids; and 3. Any other procedure involving the potential for an exposure incident for which a needleless

system is available as an alternative to the use of needle devices. Safe Needle Devices: When needleless systems are not used or cannot be used, needles with engineered sharps injury protection are to be used during: 1. Withdrawal of body fluids; 2. Accessing a vein or artery; 3. Administration of medications or fluids; and 4. Any other procedure involving the potential for an exposure incident for which a needle device

with engineered sharps injury protection is available. Non-Needle Sharps: If sharps other than needle devices are used, these items shall include engineered sharps injury protection. Preventing Contamination: Unnecessary contamination to yourself and others can be prevented by observing these additional procedures: Always clean up spills of blood or OPIM promptly and disinfect spill site. Decontaminate workbench and laboratory equipment after liquid spills. Place contaminated disposable items in appropriate containers (red bags or sharps

container). Shield machines and equipment which could emit aerosols or splashes. Use biological safety cabinets for all research procedures involving blood or OPIM. Decontaminate reusable instruments and devices before reprocessing. Choose a suitable specimen container. Avoid contaminating the outside of the

container and be sure the lid is on tight. Decontaminate the outside of the container before transporting.

Never pipette by mouth. Use a pipetting aid.


SECTION IV: CONTACT INFORMATION

Office of Medical Student Affairs 1265 Welch Road, MSOB, Suite X341

Stanford, CA 94305-5404 FAX: 650-725-7855

Caroline Cheang, MBA, Assistant Director of Clerkship Administration Phone: 650-498-7619 / Email: [email protected]

Ray Jackman, Advising Coordinator

Phone: 650-724-9622 / Email: [email protected]

Eva Vasquez, Assistant Registrar Phone: 650-724-8668 / Email: [email protected]

Mijiza M. Sanchez, MPA, Director of Medical Student Affairs Phone: 650-498-4945 / Email: [email protected]

Neil Gesundheit, MD, MPH, Associate Dean for Medical Student Advising


Susan Knox, MD, PhD, Advising Dean Phone: 650-725-2720 / Email: [email protected]

Amy Ladd, MD, Advising Dean


Oscar Salvatierra, MD, Advising Dean Phone: 650-498-5677 / Email: [email protected]

Eric Sibley, MD, PhD, Advising Dean


Rebecca Smith-Coggins, MD, Associate Dean for Medical Student Life Advising Phone: 650-725-5066 / Email: [email protected]

Kerri Wakefield, PhD, Associate Director for Student Wellness


Elizabeth Stuart, MD, MS, Assistant Dean for Clerkship Education Phone: 650-725-8314 / Email: [email protected]

Sara Clemons, Assistant Director for Clerkship Education


SECTION I. THE CLERKSHIP CURRICULUM 9SECTION II. ENTERING CLERKSHIP DRAW REQUESTS ONLINE 152014-2015 Calendar of clerkship periodsDates for Scheduling Visiting Students

Clerkship Year 2014-2015 Period dates2015-2016 Calendar of clerkship periodsDates for Scheduling Visiting Students

Clerkship Year 2015-2016 Period dates2014-2016 Clerkship scheduling calendarAdvice from the Advising Deans March 2014

Section I. The clerkship CurriculumRequired Clerkships:Selective I: Fundamentals of Clinical CareSelective II: SubinternshipIndex of Clinical ClerkshipsClerkships With No Core Clerkship PrerequisitesClerkships Offered for Two WeeksClerkships Requiring Prior Approval Before RegisteringSpecial Clinical Electives (398A Clerkships)

Section II. Entering Clerkship Draw Requests Via the Online Clerkship Fishbowl systemThe Clerkship Scheduling Process 2014Clerkship Petitions CommitteeClerkship Draw ProgramVisual Representation of the ScheduleEntering Draw Requests For Academic Years 2014-2016The Second Draw

Section III: OTHER CLINICAL REQUIREMENTSStudent Duty Hours and Work Environment

Supervision of studentsDuty hoursIn-house call activitiesRespectful Educator and Mistreatment Policy

I. StandardsA. Stanford School of Medicine (SoM) is committed to providing a work and educational environment that is conducive to teaching and learning, research, the practice of medicine and patient care. This includes a shared commitment among all members of ...B. Conduct inconsistent with this policy can occur in a variety of forms and may seriously impair learning. In particular, instructional personnel are expected to create an environment in which feedback regarding their performance can be given openly... Sexual harassment Physical or verbal abuse Assigning duties as punishment rather than education Requiring a student to perform personal services (such as shopping or babysitting) Unwarranted exclusion from reasonable learning or professional opportunities Evaluation or grading on inappropriate criteria (or threatening to do so) Harassment or discrimination on the basis of sex, race, age, color, disability, religion, sexual orientation, gender identity, national or ethnic origin, or any other characteristic protected by applicable lawC. Note: The expectations stated in this policy primarily relate to the standards of conduct for instructional personnel. For their part, medical students are expected to adhere to similar standards of respectful and professional behavior, including ...II. Guidelines For ApplicationA. These standards of conduct are applicable to all SoM instructional personnel (including faculty, residents and other members of the healthcare team) in their interactions with Stanford medical studentswhether on or off campus and whether in formal...B. In general, a determination of whether specific conduct is inconsistent with this policy will depend on a case-by-case analysis of the particular facts and circumstances, and the use of a reasonable medical student standard.C. Students subjected to abuse, discrimination, mistreatment or harassment have a right to seek timely and effective remediation with the full support of the SoM and Stanford University. In addition, retaliation and/or reprisals against an individual...D. Conduct inconsistent with this policy may consist in repeated actions or may even arise from a single incident if sufficiently egregious.E. In the review of conduct under this policy, other Stanford University and SoM policies and procedures (such as Stanfords Sexual Harassment and Consensual Sexual or Romantic Relationships Policy) may become relevant.III. The Respectful Educator and Mistreatment CommitteeGuidelines for Coordinating Clerkship and MedScholars ProjectsINDE 297: Reflections, Research and Advances in Patient CareWorking in the Clinical and Lab Setting: Universal Precautions

Links for Other Clinical RequirementsUNIVERSAL PRECAUTIONSSection IV: CONTACT INFORMATION

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Clerkship Scheduling Hand Out 2014

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